Steroid Side Effects: Addressing Hiccups from Medication

Steroid side effects and the issue of hiccups?

Hello Dr.
Huang: Recently, I sought medical attention due to a severe allergic reaction to urushiol.
The doctor prescribed oral medication and betamethasone ointment.
Prior to the allergy, I was undergoing treatment for eczema with hydrocortisone ointment.
Could the hiccup issue be caused by the overlapping use of these two ointments at a high concentration? If the allergic symptoms have subsided and there is no itching, can I stop applying the betamethasone ointment, or should I complete the three-day course of oral medication before discontinuing its use? (The hiccups are not severe but quite bothersome.) Thank you, Dr.
Huang.

ziya, 30~39 year old female. Ask Date: 2020/04/10

Dr. Huang Shenggang reply Pharmacology

Hello Mr.
Seed, thank you for your question.
Regarding Betamethasone ointment and Gandemethasone ointment, both contain the same active ingredient, betamethasone.
Therefore, I'm not sure if you are seeing the same physician who prescribed these ointments, as they are essentially the same medication.
I recommend not using them simultaneously.
Additionally, hiccups caused by medication are not common for everyone using corticosteroids, and they typically occur in individuals with a specific predisposition, with an incidence rate of about 1%.
Furthermore, it is quite rare for topical medications to cause hiccups.
I suggest confirming with your physician whether the medication is indeed the cause.
Thank you.

Reply Date: 2020/04/10

More Info

When it comes to the use of topical corticosteroids like Betamethasone and other medications, it's important to understand the potential side effects and interactions that can arise. In your case, you are experiencing hiccups, which can be a somewhat unusual side effect but is not entirely unheard of when using corticosteroids.
Corticosteroids, including Betamethasone, are anti-inflammatory medications commonly used to treat various skin conditions, including allergic reactions and eczema. While hiccups are not a direct side effect of topical corticosteroids, they can occur due to several reasons, including irritation of the diaphragm, which can be influenced by systemic absorption of the medication, especially if used in large amounts or over a prolonged period.
In your situation, if you are using both Betamethasone and another corticosteroid ointment (like Ganderstone) concurrently, it is possible that the cumulative effect of these medications could lead to increased systemic absorption, particularly if applied over large areas of skin or under occlusive dressings. However, the likelihood of hiccups being caused by this overlap is relatively low, and it is more likely that they are coincidental or related to other factors such as stress, dietary habits, or even the allergic reaction itself.

Regarding your question about whether you can stop using Betamethasone now that your allergic symptoms have improved, it is generally advisable to follow your physician's guidance. If your symptoms have significantly improved and you are no longer experiencing itching or discomfort, it may be reasonable to discontinue the Betamethasone. However, if your doctor prescribed a specific duration for treatment, it is best to complete the course unless advised otherwise. Stopping corticosteroids abruptly, especially if used for an extended period, can sometimes lead to a rebound effect where symptoms may return or worsen.

If you are concerned about the hiccups, it would be prudent to discuss this with your healthcare provider. They can assess whether the hiccups are related to your current medication regimen or if they might be due to other causes. Additionally, if you find that the hiccups persist or worsen, it may warrant further investigation to rule out other underlying issues.

In summary, while hiccups are not a common side effect of topical corticosteroids, they can occur in some cases. It is essential to communicate with your healthcare provider regarding your symptoms and the use of your medications. They can provide personalized advice based on your specific situation and ensure that your treatment plan is both effective and safe. Always follow your doctor's recommendations regarding the duration and method of using any prescribed medication, and do not hesitate to reach out if you have concerns about side effects or interactions.

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